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Better than half a million people die from heart disease in the U.S. every year, and I’m sure the peaking stress levels of the last couple years haven’t helped. I am coming fresh off of a series of cardiovascular tests that taught me a few things not only about my heart health, but about how heart science has changed and improved over the last couple of decades.

The problem is most of us know precious little about the diagnostic tests and tools that, if engaged early enough, can help save our lives. In this article I’d like to give you a sense of what I experienced and pass along some knowledge gained in the process.

The first test I underwent was an EKG (electrocardiogram), which has been the front line test of cardiac diagnostics for many years. It’s still an excellent test for detecting heart-function irregularities by tracking the electrical activity of the heart (which is translated into a line that spikes and dips across the EKG monitor). But it can’t delve deeper into what is causing the irregularities. If something odd shows up, your doctor will likely refer you to a cardiologist for further testing.

Cardiologists have several diagnostic tools available to investigate what’s going on in your heart and vasculature, and the first one you’ll probably experience is a stress test. In my case, I was slated for a nuclear dye test, both while under stress and while resting.

Nuclear dye is just as it sounds: a trace amount of radioactive material is injected intravenously and circulates throughout the bloodstream. Once it circulated for 10 minutes, I was asked to sit upright inside a circular, open capsule for a Cardiac Computed Tomography (CT) scan. The CT scan lasts about 15 minutes, during which time images of the heart and surrounding vasculature (arteries, veins, aorta) are taken. The dye contrasts with body tissue in the images and allows the cardiologist to determine if major blockages are evident in any of the vessels.

The stress test is a repeat performance of the resting test, with the addition of 10 minutes on a treadmill. This may seem like a short amount of time, but increasing speeds and a 15% incline—added to the fact that you can’t eat anything for several hours before the test—make it more difficult than you’d think. Right around eight minutes I hit my maximum heart rate of 157 and the technician injected me with more nuclear dye. You can also expect to be hooked up to an EKG machine during the test and to have your blood pressure taken multiple times. After the treadmill, I was again seated inside the CT scanner and another round of images were taken.

If you are unable to do the treadmill test, the technician will instead inject you with a chemical that will elevate your heart rate without physical exertion. This is commonly done for elderly patients.

Your cardiologist will go over the results of the scans with you and let you know if any significant blockages were found. What’s important to know is that the images will only show blockages between 50 and 70% or greater. If your results don’t show that level of obstruction, that does not mean you are free and clear of cardiovascular disease. Rather, it means that you do not have blockages that require immediate action, possibly surgery.

After the stress test, your cardiologist may or may not opt to have you undergo another type of CT test called a Calcium-score Screening Heart Scan. This test is a rather major advance in heart diagnostics. In the past, if someone passed a stress test they were sent home with a hearty assurance that they were fine. We now know that just isn’t so. Bill Clinton had multiple stress tests, all of which came back negative, not long before he had quadruple bypass surgery.

The issue is that calcified plaque on your arterial walls can be just as dangerous, in some cases more dangerous, than a significant blockage. If the plaque pulls away from the arterial wall, it can rupture the vessel resulting in blood clotting, a condition known as thrombosis. The clot may then form an obstruction in the vessel that blocks blood flow, leading to a heart attack. If the thrombosis becomes detached and free-floats through the blood system (becoming an embolus), it may eventually lodge in a vessel and cause a heart attack or stroke.

The calcium-score CT scan reveals how much, if any, hardened plaque is in your blood vessels. It’s a simple, non-invasive test in which you lay flat under what looks like a giant metal doughnut for about 10 minutes while images of your heart and surrounding vessels are taken from multiple angles. Other than the CT scanner sounding like a jet engine, it’s about as vanilla as any test can be.

After the test, you’ll be presented with a report that shows your calcium score -- the lower the score the better. I was pleased to receive a 0.0, which puts me in the 90th percentile for men my age and at about a 2% risk of a heart attack within the next 10 years. As the scores increase, so does the risk. As an example, Tim Russert was given a calcium score of 210 when he was 48 years old. He died of a major heart attack 10 years later. The calcium score was the first test that indicated he was at risk, and unfortunately he wasn’t able to outrun it.

Getting a low score on the calcium test is good, but it does not entirely rule out future heart disease. The reason is that soft plaques are not detected by the CT calcium scan, so the possibility of eventually developing "soft plaque atherosclerosis” is still a real one. The good news is that there is also a CT scan available to detect fatty deposits that constitute soft plaque, called a Coronary CT Angiography (CTA). I personally haven’t had this test, but my understanding is that if you show significant hard plaque buildup, this is likely the next test you’ll be scheduled for.

If you’re wondering if you should be asking your doctor about these tests, and you are older than 40 and/or have a family history of heart disease, it’s probably not a bad idea. Even if your cholesterol is under control and you don’t have high blood pressure, it’s still possible to have blood vessel obstructions. A high percentage of heart attack victims do not have high LDL or low HDL cholesterol. Blood tests can indicate potential cardiovascular risk, but they can only shed light on one part of the overall picture.

One final observation about paying for these tests: If you are like most of us who don’t have a gold-plated insurance plan, expect your insurance company to challenge your doctor’s reasons for wanting you to have the tests. It’s a toxic irony that the same tests that can help prevent you from ending up in intensive care also require a ridiculous amount of time and effort to get approved, if they are approved. In my case, I paid out-of-pocket for the Calcium-score test because my cardiologist strongly recommended it but my insurance deemed it unjustified. Odd, because it certainly seems like the cost of bypass surgery a few years down the road would outweigh the relatively meager cost of this test, but such is the logic of the industry.

David DiSalvo is the author of the best-selling book "What Makes Your Brain Happy and Why You Should Do the Opposite", which has been published in 15 languages, and the

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David DiSalvo is the author of the best-selling book "What Makes Your Brain Happy and Why You Should Do the Opposite", which has been published in 15 languages, and the books "Brain Changer: How Harnessing Your Brain’s Power to Adapt Can Change Your Life" and "The Brain in Your Kitchen". His work has appeared in Scientific American Mind, Forbes, Time, Psychology Today, The Wall Street Journal, Slate, Esquire, Mental Floss and other publications, and he’s the writer behind the widely read science and technology blogs “Neuropsyched” at Forbes and “Neuronarrative” at Psychology Today. He can be found on Twitter @neuronarrative and at his website, daviddisalvo.org. Contact him at: disalvowrites [at] gmail.com.